1. Case Report: Atypical Cutaneous Presentation of Human T-cell Lymphotropic Virus Type 1-Related Adult T-cell Lymphoma.
- Author
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Avallone G, Trunfio M, Mastorino L, Agostini A, Merli M, Rubatto M, Caracciolo D, Calcagno A, Senetta R, Fierro MT, Quaglino P, and Ribero S
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antiviral Agents therapeutic use, Human T-lymphotropic virus 1, Humans, Interferon alpha-2 therapeutic use, Italy, Leukemia-Lymphoma, Adult T-Cell diagnosis, Leukemia-Lymphoma, Adult T-Cell drug therapy, Leukemia-Lymphoma, Adult T-Cell virology, Male, Nigeria ethnology, Skin Neoplasms diagnosis, Skin Neoplasms drug therapy, Skin Neoplasms virology, Zidovudine therapeutic use, Leukemia-Lymphoma, Adult T-Cell pathology, Skin Neoplasms pathology
- Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus endemic in many parts of the world. Because of migration, cases of HTLV-1 in non-HTLV-1 endemic countries have been increasingly reported. Clinical presentation of HTLV-1 infection is highly variable, with a significant risk of diagnostic delays. Skin can be the first site affected by HTLV-1-related manifestations such as cutaneous involvement of adult T-cell leukemia/lymphoma (ATLL) and infective dermatitis associated with HTLV-1. A 32-year-old Nigerian man was admitted to the infectious disease department for high fever, asthenia, lymphocytosis, and vesicular bullous lesions on both hand palms and lower limbs. After clinical work-up was performed, bacterial superinfected herpes simplex viurs-2 ulcers were the presenting sign of HTLV-1-related chronic type ATLL. Standard treatment based on interferon-α plus zidovudine was started, but it was poorly tolerated; therefore, switching to an off-label dual antiretroviral regimen was attempted. The increasing prevalence of HTLV-1 in nonendemic areas may enhance the development of alternative treatments with better efficacy and tolerability profiles.
- Published
- 2021
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